Aim: study of threshold ratios between indicators of acoustic impedance and threshold tonal audiometry in military personnel – participants in hostilities. Materials and methods: the results of audiometric and impedancemetric examinations of 43 servicemen aged 18 to 42 years who received combat acute trauma in the period March-August 2022 and 20 patients with severe sensorineural deafness (2, 3, 4 stages according international classification) of non-acutraumatic genesis as a comparison group. Results and their discussion: During the examination of 43 soldiers, it was found that with significant sensorineural hearing loss on both sides (3 and 4 stages according international classification), the patients registered a full-fledged acoustic reflex during ipsilateral and contralateral stimulation. When conducting an impedanceometric examination of patients in the comparison group, it was found that in most patients the acoustic reflex was not registered at all. Conclusions: 1. In combat acute acoustic trauma, it is possible to register acoustic middle-ear-muscle reflex with severe hearing loss, which may be caused by damage to the receptor part of the auditory analyzer and the accompanying symptom of the phenomenon of accelerated loudness, by a central mechanism, or by a combination of central and peripheral mechanisms. 2. Dissociation of acoustic middle-ear-muscle reflex threshold values and threshold tonal audiometry is a characteristic feature of acutraumatic damage to the auditory analyzer. 3. Identified features, such as registration of acoustic middle-ear-muscle reflex in severe hearing loss, dissociation of acoustic reflex thresholds and tonal audiometry may be useful for further study of the pathogenesis of combat acute trauma, which, in turn, will contribute to improving the quality of diagnosis and finding ways to correct disorders of the auditory system in individuals, who suffered as a result of hostilities.

Aim: study of the characteristics of the acoustic stapedius-muscle reflex in conjunction with the data of threshold tone audiometry in combatants with different dynamics of the course of sensorineural hearing loss. Materials and methods: The characteristics acoustic stapedius-muscle reflex and the indicators of threshold tonal audiometry in combatants with different dynamics of sensorineural hearing loss were conducted. 60 military personnel were examined: group 1, with positive dynamics after treatment, group 2, in which progression sensorineural hearing loss took place, 30 people per group. Results and discussion: The study showed that patients who received combat acutrauma showed significant changes in the qualitative and quantitative characteristics of the acoustic stapedius-muscle reflex, which may indicate that they have disorders in the brainstem of the auditory analyzer. In patients with progressive sensorineural hearing loss, these disorders are more pronounced. Thus, they observed a significant (p<0.01) decrease in amplitude not only compared to the control, but also with the indicators of the group with positive dynamics. In addition, in the group with progressive course (group 2) there is a greater "dissociation" of acoustic stapediusmuscle reflex – a larger number of patients with no acoustic stapedius reflex, "asymmetric" acoustic stapediusmuscle reflex. When examining patients with combat acutrauma, we recommend examining both the peripheral (according to threshold tonal audiometry) and brainstem (according to acoustic stapedius-muscle reflex) department of the auditory system, which will not only identify disorders and prescribe the necessary treatment, but also assess the severity and predict the course of disorders in such patients. Therefore, acoustic stapedius-muscle reflex and its amplitude indicators should be used as diagnostic and prognostic criteria when conducting expert examinations of this category of patients. Conclusions: 1. In combat acutrauma there are violations both in the peripheral department of the auditory analyzer according to the threshold tonal audiometry, and in the central (brainstem) according to acoustic stapedius-muscle reflex. 2. In combat acutrauma there is a significant (p<0,01) decrease in the amplitude of acoustic stapediusmuscle reflex, more pronounced in fighters with progressive SNP. 3. "Asymmetry" of acoustic stapedius-muscle reflex, pronounced decrease in the amplitude of the acoustic reflex, "dissociation" of acoustic reflex indicators with the results of audiometric examination is not only a typical sign of hearing loss in fighters with acute trauma, but can be a prognostic marker and one of the criteria disorders in this category of patients. 4. When examining patients with combat acutrauma, it is advisable to study the characteristics of acoustic stapedius-muscle reflex.